Orthopedic or Prosthetic Support Device

ABSTRACT

An orthopedic or prosthetic support device is arranged to conform and secure to a limb of a wearer. The device includes a resilient support member adapted to extend about a limb, and a tensioning element associated with the support member. An adjustment system is connected to the support member and engages the tensioning element. The adjustment system is arranged to incrementally adjust and retain the tensioning element relative to the support member.

CROSS-REFERENCE TO RELATED APPLICATION

This application claims the benefit of priority from U.S. ProvisionalApplication No. 60/935,628, filed on Aug. 23, 2007.

FIELD OF THE INVENTION

This invention relates to support devices for use in orthopedic andprosthetic systems. Particularly, the orthopedic and prosthetic supportdevices described herein are arranged for providing support atincremental levels on the anatomy of the wearer in replacement of or insupplement to strapping systems.

BACKGROUND

In many orthopedic and prosthetic systems, straps are employed forsecuring elements to the anatomy of the wearer. Such straps may provecumbersome to the wearer to apply, and may also be difficult for somewearers to adjust.

While there have been attempts to overcome such shortcomings, manysolutions are complicated and add bulk to components such thatadditional structure is provided which may protrude from any orthopedicor prosthetic device. Further, many of such solutions, merely provide analternative to a strap and do not both replace a strap and providebracing support.

Thus, there is a need that exists for an orthopedic or prostheticsupport device that makes donning and doffing easy in a streamlinedmanner, yet enables sufficient support to the limb of the wearer.

SUMMARY

In accordance with an exemplary embodiment of the invention, anorthopedic device comprises a substantially rigid frame member, aresilient support member mounted to the frame member, and an elongatetensioning element associated with the support member. The tensioningelement defines first and second ends such that the first end is fixedlysecured to the support member and the second end is movable relative tothe support member. The tensioning element is preferably arranged in alongitudinal direction of the support member.

The brace further includes an adjustment system that is connected to thesupport member and engages the tensioning element second end. Theadjustment system is arranged to incrementally adjust and retain thetensioning element second end relative to the support member. The framemember may be mountable on a human limb solely by the support member.The support member is adapted to securely fit and conform to the humanlimb via adjustment of the tensioning element by the adjustment system.

The support member can simultaneously provide support by distributingforces exerted on a limb, and serve to secure itself and othercomponents to the limb of the wearer.

According to one variation of the embodiment, the tensioning element islocated and retained within a channel defined by the support member. Thetensioning element defines an anchor located at the first end and isfixedly secured to the support member. This embodiment is particularlyadvantageous in that the tensioning element does not protrude from thesupport member, and does not add additional bulk to the support member,thereby contributing to and/or maintaining a streamlined support memberwhich is not materially altered from a support member without thetensioning element.

The adjustment system may include a ratcheting device that includes arotational device and a handle. Adjustment of the handle permitsincremental adjustment of the tensioning element relative to the supportmember. The handle may be mounted on a frame member and the ratchetingdevice is supported within or by the fame member, and arranged to engagethe tensioning member.

The support member may define a plurality of openings and materialportions surrounding the openings. The tensioning element may bearranged to extend through only the material portions of the supportmember in a channel defined therein. The support member may define amain body having a main thickness. The main body may have a plurality oflocalized sections defined by a reduced thickness relative to the mainthickness thereby accommodating bending of the support member as thetensioning element is adjusted in order to better conform to the limb ofthe wearer. The reduced thickness sections are generally arrangedperpendicular to the direction of the tensioning element. The reducedthickness sections are particularly advantageous in part to enhance theresiliency in a bending direction toward the anatomy of the wearer,without increasing bending capabilities away from the anatomy.

According to another exemplary embodiment, the frame member definesfirst and second segments depending from a central portion, and thesupport member defines first and second segments. The support member issecured to the frame member central portion and the first and secondsegments extend therefrom. The adjustment system is secured to thecentral portion and is connected to the tensioning element. Thetensioning element includes first and second cables wherein the firstcable corresponds to the first support member segment, and the secondcable corresponds to the second support member segment.

In yet another embodiment, a first surface of the support member issecured to the frame member and a second surface of the support memberopposite the first surface includes a frictional feature. The frictionalfeature may be padding or compressible material having a perforatedsilicone or frictional foam type material. Alternatively, a silicone orfoam type coating may be applied directly to the support member withoutany additional padding material, and of a thickness sufficient toprovide some form of padding alone from the silicone or foam typematerial. Advantageously, in combination with the bending caused by thetensioning member, the frictional feature assists in maintaining thesupport member on the wearer without additional strapping means.

According to another embodiment, an orthopedic or prosthetic devicecomprises a flexible support member having a curved segment, and a firstend. The device also includes an elongate tensioning element associatedwith the curved segment of the support member. The tensioning elementmay have first and second ends, wherein the first end is anchored to thesupport member first end. The device also has an adjustment system whichis connected to the support member and the tensioning element secondend. The adjustment system is adapted to rotatably adjust the positionof the tensioning element second end relative to the support memberthereby adjusting the curvature of the curved segment.

A frictional feature, either applied directly to the support member orvia padding to the support member, is provided in combination with thesefeatures to prevent any slippage of the support member when it issecured onto anatomy.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other features, aspects, and advantages of the presentinvention will become better understood with regard to the followingdescription, appended claims, and accompanying drawings,

FIG. 1 is a perspective view of an embodiment of an orthopedic braceshowing support members in an “open” configuration.

FIG. 2 is a perspective view of the orthopedic brace according to FIG. 1showing the support members in a “closed” configuration.

FIG. 3 is a sectional view of the orthopedic brace according to FIG. 1showing support members in an “open” configuration.

FIG. 4 is a sectional view of the orthopedic brace according to FIG. 1showing support members in a “closed” configuration.

FIG. 5 is a perspective view of another embodiment of an orthopedicdevice in an “open” configuration.

FIG. 6 is a perspective view of the orthopedic device according to FIG.5 in a “closed” configuration.

FIG. 7 is an exploded view of the orthopedic device according to FIG. 6.

FIG. 8 is a perspective view of another embodiment of an orthopedicdevice in an “open” configuration.

FIG. 9 is a perspective view of the orthopedic device according to FIG.8 in a “closed” configuration.

FIG. 10 is a sectional view taken along line X-X in FIG. 8.

FIG. 11 is a sectional view taken along line XI-XI in FIG. 9.

FIG. 12 is a sectional view taken along line XII-XII in FIG. 9.

DESCRIPTION OF VARIOUS EMBODIMENTS A. Overview

A better understanding of different embodiments of the invention may behad from the following description read in conjunction with theaccompanying drawings in which like reference characters refer to likeelements.

While the disclosure is susceptible to various modifications andalternative constructions, certain illustrative embodiments are shown inthe drawings and are described below in detail. It should be understood,however, that there is no intention to limit the disclosure to thespecific embodiments disclosed, but on the contrary, the intention is tocover all modifications, alternative constructions, combinations, andequivalents falling within the spirit and scope of the disclosure.

It will be understood that, unless a term is expressly defined in thispatent to possess a described meaning, there is no intent to limit themeaning of such term, either expressly or indirectly, beyond its plainor ordinary meaning.

Any element in a claim that does not explicitly state “means for”performing a specified function, or “step for” performing a specificfunction, is not to be interpreted as a “means” or “step” clause asspecified in 35 U.S.C. §112, paragraph 6.

B. Environment and Context of Embodiments

Numerous orthopedic and prosthetic support member embodiments aredescribed herein, with an exemplary discussion given to braces directedto the knee joint and surrounding areas. The orthopedic and prostheticsupport member embodiments may serve in preventative or remedialcapacities. While the orthopedic and prosthetic devices is describedwithin the context of a preferred embodiment that is directed tosecuring the knee joint, many of the features described herein may beextended to orthopedic braces that secure other joints and body parts,such as the wrist, elbow, shoulder, ankle and neck.

The brace embodiments and features thereof may be dimensioned toaccommodate different types, shapes and sizes of human joints andappendages. In addition, embodiments may be modified to orient principalforces exerted by strap systems of the embodiments at any desirablelocation to secure the brace onto a leg in order to stabilize the knee.

For explanatory purposes, each orthopedic or prosthetic systemembodiment or component thereof described herein is divided intosections which are denoted by general anatomical terms for the humanbody. Such anatomical terms are provided to distinguish various elementsof the brace embodiments from one another, but which are not to beconsidered to limit the scope of the invention.

Each of these terms is used in reference to a human leg, by way ofexample, which is divided in similar sections with a proximal-distalplane generally extending along the meniscus of the knee between thefemur and tibia. The terms “proximal” and “distal” generally refer tolocations of the brace that correspond to the location of leg relativeto the point of attachment of the leg to the body. The terms “upper” and“lower” may be used in combination with “proximal” and “distal” toconnote gradations in location of “proximal” and “distal.” The locationat where the brace corresponds to the knee joint is used herein togenerally delimit the proximal and distal sections of the brace.

The embodiments of the knee brace can also be considered to fall within“anterior” and “posterior” sections by an anterior-posterior plane. Theanterior-posterior plane generally corresponds to the coronal or frontalplane of a human leg which lies along the central longitudinal axis of abody. A posterior side or element is therefore located behind thisanterior-posterior plane, whereas an anterior side or element is locatedin front of the anterior-posterior plane.

The term “inwardly” is commonly used herein to distinguish the side ofthe brace that may direct to the posterior side of the brace andspecifically adjacent to the leg of the wearer of the brace.Contrariwise, the term “outwardly” is the used to denote the side of thebrace that is opposite to the inwardly side.

The terms “medial” and “lateral” are relative terms that are generallyunderstood as indicating location near the midsaggital plane or midline.Therefore, elements that are located near the midline are referred to as“medial” and those elements that are further from the midline areconsidered to be “lateral.” The term “central” is used to denote thearea along the midline of a joint thereby dividing and sharing regionsof the medial and lateral regions.

From these terms, it follows that the anterior section of the brace hasthe following quadrants: (I) proximal-medial, (II) distal-medial, (III)distal-lateral, and (IV) proximal-lateral. The posterior section of thebrace has the following quadrants: (V) proximal-medial, (VI)distal-medial, (VII) distal-lateral, and (VIII) proximal-lateral.Structural members and features thereof will fall within one of thequadrants is specifically referenced in relation to such quadrant,either in its entirety or partially.

The terms “rigid” and “flexible” are repeatedly used herein todistinguish characteristics of portions of the brace. The term “rigid”is intended to denote that the frame is devoid in flexibility. Withinthe context of frame members that are “rigid,” it is intended toindicate that they may break if bent with sufficient force. On the otherhand, the term “flexible” is intended to denote that features arecapable of repeated bending. The term “resilient” is used to qualifysuch features are generally returning to the initially molded shapewithout permanent deformation. Yet, such resiliency is considered toprovide some resistance to bending and thereby provide some degree ofsupport.

The anatomical and characteristic terms described herein are notintended to detract from the normal understanding of such terms asreadily understood by one of ordinary skill in the art of orthotics.Moreover, the elements of the embodiments described herein are intendedto embrace embodiments that generally correspond to the aforementionedanatomical sections. In other words, it is understood that the elementsof the brace embodiments described herein may deviate from fallingexactly within the confines of the aforementioned anatomical sections.

C. Various Embodiments of the Orthopedic and Prosthetic Device

In observing the embodiment of FIGS. 1-4, an embodiment of an orthopedicor prosthetic system for use with the support device is shown andgenerally designated 10. For explanation purposes, the orthopedic orprosthetic system 10 is a knee brace configured for securing to a leg ofa user. While depicted in the context of a knee brace, it is readilyapparent to the skilled artisan from the discussion herein that theorthopedic and prosthetic support device and particular features thereofof the present invention may be adapted to be secured other parts of thebody to treat joints apart from the knee.

The orthopedic brace 10 comprises substantially rigid proximal anddistal frame members 12, 14, that are connected to one another byrotational hinges 32, 34. The proximal and distal frame members 12, 14preferably have arcuate configurations which are arranged to accommodatethe contours of a leg. In addition, the proximal and distal framemembers 12, 14 define center portions 24, 26, respectively, generallydefined at a central or mid-span portion of the proximal and distalframe members 12, 14.

The orthopedic brace 10 includes substantially flexible and arcuatesupport members 16, 18 that are mounted to a posterior surface of theframe members 12, 14, respectively. The support members 16, 18, as FIG.2 contrasted with FIG. 1, are arranged to be adjusted in curvature,thereby permitting conformance to and adjustmnent for sizes on a leg,and be adjusted to the degree to secure to a leg without circumferentialstraps. While flexible, these support members 16, 18 may be constructedfrom resilient material and have openings 30 to provide ventilation ofthe support members.

The support members 16, 18 of this embodiment have first and secondsegments 42, 44 which depend from a central portion 46 secured to thecentral portions 24, 26 of the frame memnbers. The first and secondsegments 42, 44 extend outwardly from the central portions 24, 26 so asto flex relative to the central portions 24, 26.

The orthopedic device 10 also includes a plurality of tensioningelements 36 that are associated with the support members 16, 18. Thesetensioning elements 36, such as cables or bands, each have a first end40 that is anchored to an extreme end of a respective segment 42, 44 ofthe support members 16, 18. In this embodiment, the tensioning elements36 are preferably located within the material portions of the supportmembers 16, 18 which are contrasted from the openings 30. The tensioningelements 36 are configured to be moved relative to the support members16, 18, and thereby cause the support members 16, 18 to adjust incurvature in response to movement of the tensioning elements 36.

The orthopedic brace 10 further defines proximal and distal adjustmentsystems 20, 22 which are mounted on the center portions 24, 26, andcoupled to a second end (opposite the first end) of the tensioningelements 36. As will be defined in reference to other embodimentsdescribed below, the adjustment systems 20, 22 are arranged toincrementally adjust the curvature of the support members 16, 18 byregulating the position of the second end of the tensioning elementsrelative to the support members 16, 18.

The adjustment systems 20, 22 may be arranged so as to be housed withina recess 38 formed on the frame members 12, 14 so as to contribute to astreamlined brace without protruding features. While the adjustmentsystems 20, 22 may be withdrawn from the recess when incrementallyadjusting the tensioning elements, they are stored within the recess 38when the tensioning elements are maintained at an appropriate setting.This provides a generally continuous structure without gaps, raisedareas, sharp edges and other protuberances or recesses that may causediscomfort to the wearer of the brace. Further, it prevents elementsprotruding from the brace which may catch on objects.

A frictional feature is preferably provided on the support members byway of ventilated padding 28 having a coating of silicone. An exemplarypadding material that may be used is described in U.S. patentapplication Ser. No. 11/723,604, entitled “Spacer Element for Prostheticand Orthotic Devices,” and owned by the assignee of this disclosure.U.S. patent application Ser. No. 11/723,604 is incorporated herein byreference,

The orthopedic device 10 may function without circumferential strapsthat are common to many orthopedic devices or such conventional strapsmay be used in supplement to the support members. The support members16, 18 are incrementally sized by selective adjustment of the adjustmentsystems 20, 22. The adjustment systems 20, 22, may include a ratchetingdevice housed within the frame members and which engages or winds thetensioning members 36 associated with the support members 16, 18 so asto reduce or enlarge the curvature of the support members 16, 18 againstthe leg of the wearer. The adjustment systems 20, 22 may be set so thatthe tensioning members are securely tightened to the leg to a degreewhich will maintain the brace on the leg.

The frictional feature, such as padding 28, may be used to additionallymaintain the support members 16, 18 on the leg due to the combination ofthe tight and conforming fit of the support members and the engagementof the frictional feature on the leg. Further, since the support membersinclude openings, and the frictional feature is preferably perforated,the support members may be sized in a manner that is sufficiently largerthan conventional securing straps so as to provide more surface area togrip the leg while allowing for sufficient ventilation of the leg.

Turning specifically to the individual features of the brace 10, theproximal and distal frame members 12, 14 preferably have arcuateconfigurations which are arranged to accommodate the contours of a leg.Preferably, in the embodiment of FIGS. 1-4, the proximal and distalframe members do not yield to the contours of the leg but instead arepreformed to a particular shape that accommodates the leg. When worn,the proximal and distal frame assemblies are intended to be shaped so asto closely secure to the leg.

The proximal and distal frame members 12, 14 are each preferablyconstructed from a unitary or continuous rigid piece of material. Theframe 12 may be characterized herein as being substantially rigid. Therigidity of the frame is generally the result of both the material fromwhich the frame is constructed from and its geometry.

The material and geometry of the proximal and distal frame members aregenerally rigid along the entirety of their length such that rigidity ofthe frame assemblies has a generally high and uniform rigidity.Exemplary materials that may be used for constructing the frame includemetals such as aluminum, titanium, and steel, thermoset resin compositesystems including glass or carbon fibers, and thermoplastics that havebeen rendered rigid by way of material composition and geometry of theframe members.

It will be noted that the requirement that the frame members havesubstantially rigid properties is provided only as an exemplaryconfiguration. It will be noted that the frame may have flexibleproperties, and may further be provided in discrete segments such thatthe proximal and distal frame assemblies are segmented as opposed tocontinuous, and may be connected to one another by suitable hinges,fasteners or other suitable elements.

For a more complete description of the frame members and rotationalhinges that may be used in combination with any of the embodimentsprovided herein is described in co-pending U.S. application Ser. No.12/068,783, entitled “ORTHOPEDIC BRACE INCLUDING A PROTECTOR ASSEMBLY”and owned by the assignee of this disclosure. U.S. application Ser. No.12/068,783 is incorporated herein by reference.

In the embodiment of FIGS. 1-4, the support member 16, 18 issubstantially more flexible than the rigid frame 12. For example, whilethe rigid frame 12 does not yield to the leg when worn, the supportmembers 16, 18 is sufficiently flexible so as to bend so as to conformto the legs.

In order to increase the bending of the support members 16, 18, they maybe provided with reduced thickness portions 43 which facilitate bendingabout the anatomy upon which the support members are secured.Particularly, in the example in FIGS. 3 and 4, the portions 43 areformed along the surface of the support members 16, 18 intended to beadjacent to the anatomy of the wearer so as to enhance the direction ofthe bending.

A variety of materials may be employed to construct the support membersThe support members may be constructed from materials such as TRIAX(abs/nylon blend), polypropylene, polyethylene, nylon, carbon or glassfiber prepeg with thermosetting or thermoplastic resins, and rigid foamfrom EVA, platezote or polyurethane. The support member may also beconstructed from a generally resilient and breathable textile andreinforced with a frame. Such a frame may be formed from a substantiallyresilient material.

The support members may be constructed in any manner of the sub-shellstaught in U.S. application Ser. No. 12/068,783, so as to includepressure-relieving perimeter edge portions.

In a variation of this embodiment, the cables may be formed from a shapememory material, such as NITINOL or a shape memory polymer. According tothis variation, the shape memory based cable or band has a molded orimparted shape that is necessary to secure the support member to a leg.Upon an application of heat or a current onto the shape memory cables ofthe support member, the shape of the support member opens allowing forthe brace to be removed from the leg of the wearer. In anothervariation, the molded or imparted shape (to which the cable or bandreturns to in shape) is the open configuration. It follows that uponapplication of heat or a current to the cable or band allows for thesupport member to be shaped onto the leg.

In observing the embodiment of FIGS. 5-7, an embodiment of a supportdevice 50 is shown having an adjustment system 62. This support devicemay be used in orthopedic or prosthetic systems. The support device 50includes first and second segments 51, 53 depending from a centralportion 52. The first and second segments 51, 53 are configured toextend away from any frame member. While the adjustment system 62 isdepicted herein as being secured to the support device 50, it may besecured to the support member via a frame member, as depicted in theembodiment of FIGS. 1-4.

As exemplified in FIGS. 5 and 6, the adjustment system 62 is adapted toincrease or reduce the curvature of the support device 50. For exampleFIG. 5 shows the support device 50 as having an open configuration whichmay be set prior to the support member being secured onto a leg. Thismay be accomplished by rotating the adjustment system 62 in acounter-clockwise direction. On the other hand, FIG. 6 shows the supportdevice 50 in a closed configuration which is of a sufficient curvatureto secure onto a leg, and in which the adjustment system 62 has beenrotated in a clockwise direction.

The support device 50 of this embodiment may be constructed so as tohave a resilient frame 58 including a perimeter edge 61 and end portions63 which bound a plurality of slots 59 formed along the posterior sideof the support member. An anterior covering 65 formed from a breathabletextile or polymeric material covers the slots 59, and is secured to theperimeter edge 61 and the end portions 63. A clearance is generallydefined between the resilient frame 58 and the anterior covering 65 atregions outside of the end portions 63 and the perimeter edge 61.

In observing FIG. 7, resilient first and second bands 54, 56 having apreformed shape are provided for being adapted to change the shape ofthe support device 50. The bands 54, 56 have first ends 62 which areanchored to mounts 60 located at end portions of the first and secondsegments 51, 53. The bands 54, 56 also define pins 64 which are definedat the second ends thereof. The bands 54, 56 are generally retainedwithin the clearance defined between the resilient frame 58 and theanterior covering 65. The second ends 64 are generally movable relativeto the support device 50.

The central portion 52 of the support device 50 defines a couple ofopenings 66 that are each arranged to receive the pins 64. The centralportion 52 also defines an aperture 68 through which an axle 82 (such asa fastener) passes through and secures to the support device 50. The camwheel 70 is mounted on the axle 82 via a central aperture 72, and hascam surfaces 74, 76 which engage the pins 64. Also, a dial wheel 78 ismounted onto the axle 82 via a central aperture 80 such that the camwheel 70 is located between the support device 50 and the dial wheel 78.The dial wheel 78 has a gripping feature 86 located about the peripherythereof, and is preferably lockable in a rotational position (such as aratchet).

The adjustment system 62 is defined by the pins 64 which engage the camsurfaces 74, 76 of the cam wheel 72, and the dial wheel 78 which lockswith the cam wheel 72. It follows that rotation of the dial wheel 78 ina clock-wise direction draws the pins 64 nearer to one another and hencetoward the aperture 68. This in turn causes the first and secondsegments 51, 53 to be drawn toward one another, thereby varying thedimension of the support device 50 to accommodate a particular anatomy.

The dial wheel 78 may be rotated in a counter-clockwise direction so asto release the support device 50 from a constricted configuration. Thecam surfaces 74, 76 have limiting surfaces which represent maximum andminimum size settings of the support device 50. Therefore, a wearer islimited as to how tightly the support device 50 is applied to theanatomy so as to prevent any injury or discomfort to the wearer.

The band segments 54, 56 are preferably constructed from a resilientmaterial, such as from plastics and metals. The band segments 54, 56 arepreformed with a first curvature and may be urged into a plurality ofcurvatures so as to allow for a plurality of different size settings tothe support member. When urged into a tighter curvature that generallyhas a radius that is less than the first curvature, the band segmentsare intended to revert back to the first curvature once released fromthe tighter curvature.

As with prior embodiments, a frictional feature 84 is provided on theposterior side of the support device 50. As shown in FIGS. 6 and 7, thefrictional feature 84 is preferably provided, at least in part, on thematerial portions of the resilient frame 58 so as to work in combinationwith the adjustment system 62 to maintain the support device 50 on theanatomy of the wearer.

In accordance with another embodiment, FIGS. 8 and 9 exemplify a supportdevice 100 having a main body 102 and an adjustment system 106 whichvaries the curvature of a resilient band element 104 associated with themain body 102. The main body 102 is preferably formed from a resilientmaterial and defines a main thickness with regions of reduced thickness126. The support device 100 may be configured to accommodate a varietyof anatomy sizes, as evidenced by the size A1-A2 in FIG. 8, and the sizeB1-B2 in FIG. 9.

The adjustment system 106 is preferably a ratchet having a handle 110arranged to incrementally adjust a gear wheel 108 mounted on a ratchet112 and arranged to engage the band element 104. The ratchet maycomprise a variety of ratchets known to one of ordinary skill in the artincluding ratchet buckles, and ladder ratchets.

As shown in FIGS. 10-12, the band element 104 is retained within achannel 116 formed within the main body 102. The band element 104 has afirst end 117 which is anchored to a first end 115 of the main body 102.The band element 104 has a second end portion 119 which is movablerelative within the channel 116. The channel 116 has a length greaterthan the band element 104 in order to permit adjustment of the bandelement 104 therewithin.

An opening 122 is defined by the main body 102 whereat the gear wheel108 meshes with teeth 128 formed along a surface of the band element104. The ratchet 112 permits incremental adjustment, and pulling of thesecond end 119 of the band element 104 toward the second end 121 of thebody member 102.

As exemplified in FIGS. 10 and 11, the radius R1 of the support device100 in FIG. 10 is greater than the R2 of the support device 100 in FIG.11. In the configuration of FIG. 10, the support device 100 isconsidered to be in an open configuration for placement of the supportmember on a limb. The second end 119 of the band element 104 is adistance d1 from the second end 121 of the body member 102. FIG. 11, onthe other hand, shows the support device 100 in a tightenedconfiguration in which the second end 119 of the band element 104 hasbeen drawn a distance d2 closer to the second end 121 of the body member102.

As with other embodiments described herein, the support member may beprovided with ventilation in the form of slots 114 formed along the bodymember 102. Also, padding and a frictional feature may be provided byway of the padding 113 having a frictional layer 118. The padding 113and frictional layer may of any of the types described herein.

It will be understood that according to any of the embodiments describedherein, a corresponding brace having the support member may be providedwithout any straps which extend fully around a leg. Indeed, the supportmembers described herein are intended to obviate the need for straps,and instead it is the support member itself which serves the dualpurpose of supporting anatomy and securing a brace or correspondingstructure onto the anatomy. This, of course, does not limit theembodiments described herein so that they cannot be used with straps. Tothe contrary, the embodiments are intended to embrace orthopedic andprosthetic devices that employ and do not employ straps such as thosethat circumferentially or partially circumferentially extend aboutanatomy.

While the foregoing embodiments have been described and shown, it isunderstood that alternatives and modifications of these embodiments,such as those suggested by others, may be made to fall within the scopeof the invention.

1. An orthopedic or prosthetic support device, comprising: a resilientsupport member adapted to extend about a limb; a tensioning elementassociated with the support member, and having first and second ends,the first end being fixedly secured to the support member; an adjustmentsystem connected to the support member and engaging the tensioningelement second end, the adjustment system arranged to incrementallyadjust and retain the tensioning element relative to the support member;wherein the support member is adapted to generally conform to a limb viaadjustment of the tensioning element by the adjustment system.
 2. Thedevice according to claim 1, wherein the tensioning element isadjustably retained by the support member such that the tensioningelement moves within the support member upon adjustment by theadjustment system.
 3. The device according to claim 1, wherein thetensioning element is elongate and extends within a channel defined bythe support member.
 4. The device according to claim 1, wherein theadjustment system includes a ratcheting device holding the tensioningelement second end permitting incremental adjustment of the tensioningelement relative to the support member.
 5. The device according to claim1, wherein the tensioning element defines an anchor located at the firstend which is fixedly secured to the support member.
 6. The deviceaccording to claim 1, wherein the support member defines a plurality ofopenings and material portions surrounding the openings, the tensioningelement extending through only the material portions of the supportmember in a channel defined therein.
 7. The device according to claim 1,wherein the support member defines a main body having a main thickness,the main body having a plurality of localized reduced thickness sectionsdefined by a reduced thickness relative to the main thickness, thereduced thickness sections oriented generally perpendicular to adirection of the tensioning element.
 8. The device according to claim 1,wherein the support member defines a first surface having a frictionalfeature defined by a perforated silicone coating located directlythereon.
 9. The device according to claim 1, further comprising apadding element having a first side secured to a first surface of thesupport member, the padding element including a coating of frictionalmaterial located on a second side opposite to the first side.
 10. Anorthopedic or prosthetic device comprising: a flexible support memberhaving a curved segment, and having first and second ends; an elongatetensioning element associated with the curved segment of the supportmember, the tensioning element having first and second ends, thetensioning element first end being anchored to the support member firstend; an adjustment system connected to the support member and thetensioning element second end, the adjustment system being adapted torotatably adjust the position of the tensioning element second endrelative to the support member thereby adjusting the curvature of thecurved segment and displacing the support member first end relative tothe support member second end; wherein the support member is adapted togenerally conform to a limb via adjustment of the tensioning element bythe adjustment system.
 11. The device according to claim 10, wherein thetensioning element is located within the support member.
 12. The deviceaccording to claim 10, wherein the tensioning element comprises aresilient band.
 13. The device according to claim 10, wherein theadjustment system includes a rotatable element having a cam surfaceengaging a pin located at the second end of the tensioning element, thecam surface arranged to move the tensioning element second end relativeto the support member upon rotation of the rotatable element.
 14. Thedevice according to claim 13, wherein the support member defines anopening through which the pin extends throughout rotation of therotatable element.
 15. The device according to claim 10, wherein thesupport member defines a channel formed within the thickness thereofpermitting movement of the tensioning element therein.
 16. The deviceaccording to claim 10, wherein the support member defines a main bodyhaving a main thickness, the main body having a plurality of localizedreduced thickness sections defined by a reduced thickness relative tothe main thickness and oriented in a direction perpendicular to adirection of the tensioning element.
 17. The device according to claim10, wherein the support member is generally arcuate, and is arranged tobe adjusted thoughout a range of a plurality of radii.
 18. The deviceaccording to claim 10, wherein the tensioning element defines aplurality of teeth engageable with a ratchet mechanism of the adjustmentsystem.
 19. The device according to claim 10, wherein the tensioningelement is housed within the support member, the support member defininga cavity arranged for permitting movement of the tensioning elementsecond end relative to the support member.
 20. An orthopedic orprosthetic device, comprising: a substantially rigid frame member; aresilient support member having at least one segment depending from theframe member, the at least one segment defining first and second ends,respectively; an elongate tensioning element associated with the supportmember, the tensioning element having first and second ends, the firstend being anchored to the support member first end; an adjustment systemconnected to the support member and the tensioning element second end,the adjustment system being adapted to rotatably adjust the position ofthe tensioning element second end relative to the support member therebyadjusting a curvature of the at least one segment support memberrelative to the frame member; wherein the support member is adapted togenerally conform to a limb via adjustment of the tensioning element bythe adjustment system.